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Red Stone Lip (Chi Shi Zhi, 1 jin) Dried Ginger (Gan Jiang, 1 liang) Rice (Jing Mi, 1 sheng)

For Shaoyin disease (disease of the Shaoyin channel) presenting with diarrhea and pus-blood in the stool, this formula is indicated.

If this condition originates from transmission via the Three Yang channels (Taiyang, Yangming, Shaoyang), it is purely a heat syndrome. Cheng Wuji described it as "heat-collateral diarrhea" due to the diarrhea, and as interior cold syndrome due to the use of dried ginger. I disagree. Shaoyin corresponds to Kidney Water, which governs the consolidation of urine and feces. When Kidney Water is scorched by fire and cannot control the fire, the pathogenic fire attacks the Large Intestine (Metal element), resulting in diarrhea with pus and blood. This formula uses Chi Shi Zhi because its nature is cold and astringent; the cold nature clears heat, and the astringent nature consolidates and stops leakage. Dried Gan Jiang is used to borrow its heat to follow the treatment principle (reverse treatment), similar to adding human urine and pig bile to Baitong Decoction, or using Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian) in Ganjiang Huanglian Huangqin Renshen Decoction. Those borrow coldness, while this borrows heat; both utilize the method of borrowing to follow the disease's nature. The *Neijing* states: "Treat cold with heat, treat heat with cold. For mild cases, use contrary treatment (orthodox treatment); for severe cases, use following treatment (reverse treatment). Whether to use contrary or following treatment depends on the specific situation." This refers precisely to this case. Jing Mi (Rice) is used because we fear that the cold nature of Chi Shi Zhi might damage the Stomach Qi, so Jing Mi is added to harmonize the Stomach. If there were truly interior cold in Shaoyin, how could just one liang of Gan Jiang be sufficient to warm? Instead, one jin of Chi Shi Zhi would only suffice to exacerbate the cold and cause death! Could this be a formula by Zhang Zhongjing? Alas! Even someone as enlightened as Wang Shuhe (courtesy name Shuhe, pseudonym Liaoshe) was confused by this, so it is understandable how those inferior to him would fare.

Pulsatillae Radix (Baitouweng) Phellodendri Cortex (Huangbai) Coptidis Rhizoma (Huanglian) Fraxini Cortex (Qinpi)

For Taiyang disease presenting with heat-dysentery and tenesmus (feeling of incomplete defecation with heavy sensation), this formula is indicated.

"Heat-dysentery" refers to diarrhea accompanied by fever; "tenesmus" refers to frequent defecation with a heavy, dragging sensation. The nature of herbs is such that cold-natured herbs can eliminate heat, and bitter herbs can thicken the intestines. All four ingredients are bitter and cold, thus treating heat-dysentery and relieving tenesmus.

Prepared Licorice Root (Zhi Gancao) Immature Bitter Orange (Zhishi, bran-fried) Bupleurum Root (Chaihu, de-rhizome) Peony Root (Shaoyao, stir-fried)

For Shaoyin disease presenting with cold extremities (Sini), this formula is indicated.

This occurs when Yang pathogenic factors transmit to Shaoyin, causing stagnant heat in the interior, which prevents Yang Qi from reaching the four extremities, resulting in cold extremities that are not warm. Zhishi is used to break up stagnant Qi and clear interior heat; Chaihu is used to raise true Yang and reverse cold extremities; Gancao harmonizes the disordered Qi; Shaoyao gathers the displaced Yin fluids. Although this syndrome involves Yang pathogens in the interior, purgation is strictly contraindicated. In Taiyang disease, protecting Yang is paramount. Cold extremities indicate an advancing Yin pattern; if bitter-cold purgatives are used again, Yang will be further depleted. Therefore, it is taboo. The medical theory states: "In all cases of Sini, do not use purgation." This refers to this very situation!